Original articleDepression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos
Introduction
Depressive symptoms, depressed mood or subclinical depression, as well as anxiety, assessed with screening instruments have been associated with higher risks of heart disease, stroke, and all-cause mortality [1], [2], [3], [4]. There is a bidirectional relationship between depression and cardiovascular disease (CVD), with depression being common after myocardial infarction (MI) [5] and stroke [6].
Although the study by Alegria et al. [7] from the National Latino and Asian American Study, examined a probability sample of 2554 persons from four background groups: Mexicans, Puerto Ricans, Cubans and “other,” it did not distinguish those of Dominican, South American, or Central American backgrounds. Another important study from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (CEPS) looked only at Mexican, Puerto Rican, and Cuban background groups. Little research exists on use of antidepression and antianxiety medications in these diverse groups. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the largest most comprehensive study of the health of Hispanics/Latinos from six different national backgrounds, consists of a probability sample of 16,415 Hispanic/Latino persons aged 18 to 74 years in four different communities across the United States. HCHS/SOL provides a unique opportunity to examine depressive and anxiety symptomatology and use of antidepressant and antianxiety medications in Hispanic/Latino groups of different national backgrounds, by age, sex, and in relation to CVD and risk factors for CVD.
Section snippets
Design overview, setting and participants
The HCHS/SOL enrolled 16,415 self-identified Hispanic/Latino participants aged 18 to 74 years in four defined communities in the US: Bronx, New York; San Diego, California; Miami, Florida; and Chicago, Illinois to describe and study prospectively health and disease in Hispanic/Latinos from diverse origins, including Mexican, Puerto Rican, Dominican, Cuban, Central American, and South American. The cohort was selected and enrolled between 2008 and 2011 through stratified multistage area
Results
The self-reported background of the analytic cohort is 40% Mexican, 16% Puerto Rican, 14% Cuban, 11% Central American, 9% Dominican, and 7% South American. Women comprised 60%; the vast majority was not born in the 50 United Sates (83%) with the greatest proportion immigrating as young adults (aged 20–44 years). Spanish was the preferred language for questionnaires completion for 80.1% of the analytic cohort. The description of the analytic cohort shows raw percentages of actual participants
Discussion
In the most comprehensive study of Hispanics/Latinos of different national backgrounds conducted to date (the HCHS/SOL), we found an overall prevalence of depression of 27%. Being US born or second or higher generation, immigrant was associated with higher levels of depression and anxiety. Antidepressant and antianxiety medication was used by 5% and 2.5% of the cohort, respectively, and varied widely by Hispanic/Latino background group as well by age and sex and presence of CVD.
Those of Puerto
Acknowledgments
The authors thank the staff and participants of HCHS/SOL for their important contributions.
Investigators website: http://www.cscc.unc.edu/hchs/.
The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and
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All authors report no conflict of interest.
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Present address: Office of Biostatistics, Center for Drug Evaluation and Research, US FDA.